Individual provider Active NPI

Christian Michael Ponder, D.O.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Edmond, OK
National Provider Identifier
1841787603
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
8414 Issued in OK
Practice address
1800 Renaissance Blvd
Edmond, OK 73013-3023
Phone
(405) 359-2400
NPI assigned
Apr 17, 2018
Last updated
Aug 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 8414 OK
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X 8414 OK Primary

Addresses

Primary practice location

1800 Renaissance Blvd
Edmond, OK 73013-3023

Mailing address

16315 N May Ave
Edmond, OK 73013-8892
Phone (405) 521-0041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710005151 OK Practitioner - Ophthalmology 1850648742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of North Texas HSC, College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oculoplastic Surgeons of Oklahoma PLLCGroup PAC ID 1951345719, 4 clinicians

Practice addresses (Care Compare)

16315 N May Ave
Edmond, OK 73013-8892
Phone (405) 521-0041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.34 of 100Reported as group
Quality
80.85
Promoting interoperability
100
Improvement activities
40
Cost
76.95

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision17
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
8414OKMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oculoplastic Surgeons of Oklahoma, PLLC Ophthalmology CurrentSince Aug 19, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

16135 N May Ave
Edmond, OK 73013

16315 N May Ave
Edmond, OK 73013
Phone (405) 521-0041

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1841787603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16315 N MAY AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138892",
            "telephone_number": "405-521-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 RENAISSANCE BLVD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133023",
            "telephone_number": "405-359-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "CHRISTIAN",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OK",
            "license": "8414",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "OK",
            "license": "8414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.